Diagnosis of ectopic pregnancy

Ectopic pregnancy is caused by various reasons. The fertilized egg does not reach the uterus during migration, but stays and develops outside the uterus. The diagnosis of ectopic pregnancy is based on the following:

Symptoms and signs

1. Amenorrhea: Except for pregnancy in the fallopian tube interstitial region, the amenorrhea lasts for 6 to 8 weeks.

2. Vaginal bleeding: After the death of the embryo, there is often irregular vaginal bleeding, which is dark red in color and small in amount, generally not exceeding the menstrual volume. When there is heavy bleeding, the patient may show symptoms of shock such as pale complexion, rapid and weak pulse, and low blood pressure.

3. Abdominal examination: When there is obvious internal bleeding, there will be tenderness and rebound pain in the lower abdomen. When there is more bleeding, there will be shifting dullness on percussion. If there is repeated bleeding and accumulation, a mass may form and continue to grow and harden, and the mass can be felt in the lower abdomen.

Testing

1. Human chorionic gonadotropin measurement: This is currently an important method for early diagnosis of ectopic pregnancy.

2. Progesterone determination: The serum progesterone level of ectopic pregnancy is low, and the serum progesterone level is lower than 10ng/ml, which often indicates ectopic pregnancy, with an accuracy rate of about 90%.

3. Ultrasound diagnosis: Type B ultrasound examination is particularly commonly used for the diagnosis of ectopic pregnancy, and vaginal B-ultrasound examination is more accurate than abdominal B-ultrasound examination.

4. Diagnostic curettage: When ectopic pregnancy cannot be ruled out, a diagnostic curettage can be performed to obtain the endometrium for pathological examination.

5. Posterior fornix puncture: Posterior fornix puncture is widely used to assist in the diagnosis of ectopic pregnancy. Blood can often be drawn out and does not coagulate after placement, and contains small blood clots.

6. Laparoscopic examination: For cases that are difficult to diagnose, examination under direct laparoscope vision can provide a timely and clear diagnosis and can also be treated surgically at the same time.